Investigating the Relationship between Critical Thinking and Clinical Decision-Making with the Quality of Nursing Care: a Cross-Sectional Study

Critical thinking and the clinical decision-making power of nurses is one of the factors to improve the quality of health care. This research was conducted with the aim of determining the relationship between critical thinking and clinical decision-making with the quality of nursing care of medical surgical nurses.

This descriptive and analytical cross-sectional study was conducted on 226 nurses working in medical-surgical wards in educational and therapeutic centers affiliated to Isfahan University of Medical Sciences in 2021. Data were collected through the California Critical Thinking Skills, Clinical Decision Making, and Quality of Nursing Care questionnaires and using a multi-stage stratified sampling method. The findings were analyzed using descriptive (frequency, percentage, mean, and standard variation) and inferential tests (Pearson correlation coefficient, independent t, ANOVA) in SPSS software version 18. A significance level of P < 0.05 was considered.

The mean score of critical thinking (maxim score:35), clinical decision-making (maxim score:120), and quality of nursing care (maxim score:260) was 7.99, 87.72, and, 199.43 respectively.  They had high nursing care quality (83.2%) and, poor critical thinking (88.1%). The Pearson correlation coefficient did not show a significant relationship between the critical thinking score and the nursing care quality score (P=0.28). But the results showed a significant relationship between the clinical decision-making score and the nursing care quality score (P<0.001).

The findings showed that there was a relationship between the clinical decision-making score and the nursing care quality score, but no relationship was observed between the critical thinking score and the nursing care quality score. The critical thinking of the participants was reported to be at a weak level, therefore, the need to train nursing students and nurses in order to strengthen critical thinking and finally improve the clinical decision-making power and increase the quality of nursing care is recommended.